# Identifying Caregiving Youth and Associated Mental Health Concerns in a Medical Clinic Setting

## TL;DR

This study shows that many teens in school clinics are caregivers, and they often have higher mental health concerns like depression.

## Contribution

The study introduces a pilot screening method in healthcare to identify caregiving youth and their mental health risks.

## Key findings

- 39% of surveyed students identified as caregivers, performing tasks like cleaning and medical support.
- Caregiving youth showed higher mental health screener scores and more clinically significant depression.
- Screening in school-based clinics effectively identified caregiving youth and their mental health needs.

## Abstract

Background/ Objectives: Despite the high estimated prevalence and the documented impact of caregiving on children, there is no systematic process to identify or study caregiving youth in the healthcare setting. The aim of this study was to pilot screening in school-based clinics to identify caregiving youth and their associated mental health outcomes. Methods: From March 2021 to March 2022, ninth- to twelfth-grade students were surveyed regarding caregiving and validated mental health screeners during intake at three Title 1 school-based health clinics in Miami, FL. Results: Thirty-nine percent of participants self-identified as caregivers. The most common caregiving tasks were cleaning (n = 20, 50%), keeping company (n = 19, 48%), shopping/cooking (n = 14, 35%), dressing (n = 13, 33%), mobility support (n = 12, 30%), and medical support (n = 11, 28%). Compared to their non-caregiving counterparts, caregiving youth had higher scores on mental health screeners, and caregivers were more likely to endorse clinically significant levels of depression (p = 0.050). Conclusions: Screening in the healthcare system was effective at identifying caregiving youth in school-based clinics whose mental health may be impacted by caregiving responsibilities. Pediatricians should actively screen for both caregiving and mental health concerns. Future studies are needed to ensure the caregiving screening tool is reliable and valid for broad-scale provider use.